Prehypertension and Chronic Kidney Disease in Chinese Population: Four-Year Follow-Up Study

Xue, Hao; Wang, JianLi; Hou, Jinhong; Li, Junjuan; Gao, Jingsheng; Chen, Shuohua; Zhu, Hao; Wu, Shouling

doi:10.1371/journal.pone.0144438

Cited by 19 publications

(18 citation statements)

References 27 publications

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“…After reading the full text of 45 articles, 10 articles were removed because they did not focus on CKD, 22 records were excluded because they contained no information about prehypertension, 3 were removed because they did not compare prehypertension with normal blood pressure, and the other 3 articles were excluded because they did not report 95% CI values ( S1 Table ). Finally, 7 studies were included in our meta-analysis [ 6 – 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…Prehypertension, which was first described in the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) [ 5 ], has attracted increased attention from nephrologists. The relationship between prehypertension and the risk of CKD is controversial, with conflicting results derived from different cohort studies [ 6 – 12 ]. The Ohasama Study from Japan demonstrated a significant association between prehypertension and the development of CKD in a general population.…”

Section: Introductionmentioning

confidence: 99%

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A Meta-Analysis on Prehypertension and Chronic Kidney Disease

Yang

Xia

et al. 2016

PLoS ONE

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BackgroundRecent studies have demonstrated that there is an association between prehypertension and an increased risk of end-stage renal disease. However, there is conflicting evidence regarding the relationship between prehypertension and chronic kidney disease (CKD). This meta-analysis aimed to demonstrate the association between prehypertension and the incidence of CKD and identify the impacts of gender and ethnic differences.MethodsMEDLINE, EMBASE, Cochrane Library (from inception through March 2016) and article reference lists were searched for relevant studies regarding blood pressure and CKD. Blood pressure (BP) measurements were classified as follows: optimal BP (less than 120/80 mmHg), prehypertension (120-139/80-89 mmHg) and hypertension (over 140/90 mmHg). CKD was defined by estimated glomerular filtration rate (eGFR)<60 ml/min/1.73 m2 or proteinuria. Two investigators independently extracted the data and assessed the quality of studies enrolled in this meta-analysis using the Newcastle-Ottawa Scale (NOS). We performed the meta-analysis using Stata/SE 12.0 (StataCorp LP). The random-effect models were used in the heterogeneous analyses.ResultsAfter retrieving data from 4,537 potentially relevant articles, we identified 7 cohort studies including 261,264 subjects, according to the predefined selection criteria. Five studies were conducted in Mongolians from East Asia, and the other two studies were performed in Indo-Europeans from Austria and Iran. The participants ranged in age from 20 to 89 years, and the proportion of females ranged from 27.2% to 63.8%. The follow-up period ranged from 2 to 11 years. Compared with the optimal BP values, prehypertension showed an increased risk of CKD (pooled RR = 1.28; 95% CI = 1.13–1.44; P = 0.000; I2 = 77.9%). In the sex-stratified analysis, we found a similar trend in women (pooled RR = 1.29; 95% CI = 1.01–1.63; P = 0.039; I2 = 76.1%) but not in men. This effect was observed only in Mongolians from East Asia (pooled RR = 1.37; 95% CI = 1.18–1.59; P = 0.000; I2 = 81.3%) and not in Indo-Europeans.ConclusionsPrehypertension is considered a potential cause of CKD. Gender and ethnic differences are exhibited in this association.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Meta-Analysis on Prehypertension and Chronic Kidney Disease

Yang

Xia

et al. 2016

PLoS ONE

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“…The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) proposed high BP category, including 120–139 mm Hg systolic BP (SBP) or 80–89 mm Hg diastolic BP (DBP), designated as prehypertension [7]. According to JNC-7, individuals with prehypertension have a higher risk of developing hypertension compared with those with ideal BP levels; also, they have an increased risk of cardiovascular morbidity and mortality [5–9]. Previous studies have shown that prehypertension is related to a 1.7-fold increase in coronary artery disease and a 3.5-fold increase in myocardial infarction [10].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Risk Factors of Prehypertension and Hypertension in Southern China

et al. 2017

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BackgroundThis study aimed to describe the prevalence and risk factors of prehypertension and hypertension in Jiangxi Province, China. Individuals with prehypertension frequently progress into hypertension and are at high risk of developing cardiovascular disease and stroke.MethodsA cross-sectional survey of 15,296 participants (15 years or older) was conducted in Jiangxi Province, China, in 2013, using questionnaire forms and physical measurements.ResultsThe prevalence of prehypertension and hypertension was 32.3% (39.2% in men and 27.6% in women) and 29.0% (30.1% in men and 28.2% in women), respectively. The awareness, treatment, and control rates among all hypertensive participants were 64.8%, 27.1%, and 12.6%, respectively. The prevalence of prehypertension in males declined with age, but the prevalence of hypertension increased in different genders. The prevalence of prehypertension and hypertension increased with increasing body mass index (BMI). The prevalence of prehypertension decreased, in parallel to an increase in the prevalence of hypertension, with increasing waist circumference (WC). A combination of WC and BMI was superior to individual indices in identifying hypertension. A multivariate logistic regression analysis indicated that increasing age, high BMI, high visceral adipose index, and high heart rate were risk factors for prehypertension and hypertension. The high body fat percentage was significantly associated with prehypertension. Living in an urban area, male sex, abdominal obesity, and menopause were correlated with hypertension.ConclusionsPrehypertension and hypertension are epidemic in southern China. Further studies are needed to explore an indicator that can represent the visceral fat accurately and has a close relationship with cardiovascular disease.

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“…Moreover, a clustering of cardiovascular disease risk factors was also observed in the prehypertension population of Han and Mongolian adults [ 10 ]. A four-year follow-up study indicated that prehypertension significantly increased the occurrence of chronic kidney disease in Chinese adults [ 11 ]. Meta-analyses have demonstrated that prehypertension, as well as hypertension and diabetes, are significantly associated with the risk of cardiovascular events including coronary heart disease, stable angina and stroke.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for prehypertension and their interactive effect: a cross- sectional survey in China

Song

Xue

Zhao

et al. 2018

BMC Cardiovasc Disord

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BackgroundIndividuals with prehypertension are at higher risk of developing hypertension and cardiovascular diseases, while the interaction between factors may aggravate prehypertension risk. Therefore, this study aimed to evaluate the risk factors for prehypertension in Chinese middle-aged and elderly adults, and explore the potentially interactive effect of evaluated factors.MethodsAll the participants that came from a community based cross-sectional survey were investigated in Bengbu, China, by being interviewed with a questionnaire. Body mass index (BMI), Waist circumference (WC) and lipid accumulation product (LAP) that reflect participants’ obesity were also calculated. In addition, logistic regression model was applied to explore the risk factors of prehypertension, followed by the assessment of the interactive effects between risk factors on prehypertension by the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI).ResultsA total of 1777 participants were enrolled in this study, among which the prevalence of normtension, prehypertension and hypertension were 41.70%, 33.93% and 24.37% respectively. According to the multivariate logistic regression analysis, age (OR: 1.01, 95%CI: 1.00–1.02), smoking (OR: 1.67, 95%CI: 1.22–2.29), family history of cardiovascular diseases (OR: 1.52, 95%CI: 1.14–2.02), general obesity (OR: 1.51, 95%CI: 1.15–1.97) and LAP (OR: 2.58, 95%CI: 1.76–3.80) were all defined as the major factors that significantly related with the risk of prehypertension. When identifying prehypertension risk, the receiver-operating characteristics (ROC) curves (AUC) analysis indicated that LAP performed better than BMI in males (Z = 2.05, P = 0.03) and females (Z = 2.12, P = 0.03), but was superior to WC only in females (Z = 2.43, P = 0.01). What is more, there were significant interactive effects of LAP with family history of cardiovascular diseases (RERI: 1.88, 95%CI: 0.25–3.51; AP: 0.44, 95%CI: 0.20–0.69; SI: 2.37, 95%CI: 1.22–4.60) and smoking (RERI: 1.99, 95%CI: 0.04–3.93; AP: 0.42, 95%CI: 0.17–0.67; SI: 2.16, 95%CI: 1.68–4.00) on prehypertension risk. The value of AP (0.40, 95%CI: 0.03–0.77) also indicated a significant interaction between family history of cardiovascular diseases and smoking on prehypertension.ConclusionPrehypertension is currently prevalent in Chinese adults. This study indicated that age, family history of cardiovascular diseases, smoking, general obesity and LAP were significantly related with prehypertension risk. Furthermore, interactive effects on risk of prehypertension had been demonstrated in this study as well, which would help researchers to build strategy against prehypertension more comprehensively and scientifically.Electronic supplementary materialThe online version of this article (10.1186/s12872-018-0917-y) contains supplementary material, which is available to authorized users.

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Prehypertension and Chronic Kidney Disease in Chinese Population: Four-Year Follow-Up Study

Cited by 19 publications

References 27 publications

A Meta-Analysis on Prehypertension and Chronic Kidney Disease

A Meta-Analysis on Prehypertension and Chronic Kidney Disease

Prevalence and Risk Factors of Prehypertension and Hypertension in Southern China

Risk factors for prehypertension and their interactive effect: a cross- sectional survey in China

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